Provider Demographics
NPI:1477681757
Name:NORTH COAST ORTHOPAEDICS INC
Entity Type:Organization
Organization Name:NORTH COAST ORTHOPAEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-877-5660
Mailing Address - Street 1:104 EAST 2ND STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507
Mailing Address - Country:US
Mailing Address - Phone:814-877-5660
Mailing Address - Fax:814-877-5661
Practice Address - Street 1:104 EAST 2ND STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507
Practice Address - Country:US
Practice Address - Phone:814-877-5660
Practice Address - Fax:814-877-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013467E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
054111Medicare ID - Type Unspecified
B39738Medicare UPIN